Agree. It's important to remind people that the effects of the first few weeks aren't like the effects for the next 10-50 years.
It's especially concerning when people say the meds give them "more energy to do things" because that's more of a side effect that goes away after a while. The focus-enhancing effect is separate from the energizing/euphoric side effect that people experience in the first few weeks.
High-dose pyridoxine as an 'anti-stress' strategy
https://pubmed.ncbi.nlm.nih.gov/10859691/
Anxiolytic-like effect of pyridoxine in mice by elevated plus maze and light and dark box: Evidence for the involvement of GABAergic and NO-sGC-cGMP pathway
https://www.sciencedirect.com/science/article/abs/pii/S00913...
Your description perfectly matches my experience.
If I only get 80% of the stuff I need to get done before bedtime, there's no chance for me to do other. If I get the stuff I need to get done well before bedtime, there's time left for other things. Skewed self-assessment isn't really a factor in that.
And by the way, the effect on dopamine is secondary. ADHD meds work because they affect glutamate leveles. You all do not have low Dopamine, you have low glutamate.
https://www.nature.com/articles/nn0301_275
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966039/
https://www.brown.edu/news/2018-03-12/glutamate
And you all probably just need B6: https://pubmed.ncbi.nlm.nih.gov/24321736/
https://en.wikipedia.org/wiki/Aromatic_L-amino_acid_decarbox...
AADC is an enzyme in the path that converts amino acids into dopamine and PEA/NMPEA (see "biosynthetic pathways" in above link), the latter of which is an endogenous structural isomer of amphetamine.
You're not really making a strong case that this isn't about dopamine or that amphetamine is the wrong thing for it.
Moreover, B6 will make more of these things up until the point that it's no longer the rate limiter in their production, if it ever was. (The rate limiting step for dopamine is ordinarily AAAH converting Tyrosine into L-DOPA). And if you hit a different rate limiter before you have enough dopamine or PEA/NMPEA, what then?
https://www.uniprot.org/uniprotkb/Q99259/entry
https://www.researchgate.net/publication/340492849_The_Gluta...
I did not say it is not about dopamine, but it is, at a deeper level, about glutamate. Which is why coffee works so well for ADHD because the stimulant action from caffeine is produced by glutamate.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7700297/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4166758/
Regardless, here is so much evidence that B6 plays a large role in ADHD and what, you all just ignore it?
Caffeine also antagonizes adenosine receptors which modulate dopamine. (Caffeine is complicated. Nicotine too.)
> Regardless, here is so much evidence that B6 plays a large role in ADHD and what, you all just ignore it?
The problem is it's the same kind of thing as saying that eating more reduces nutrient deficiencies. It might be more effective than placebo. If you're deficient in one thing and you get more of everything, you get more of that. It might even be the right solution if your underlying problem is actually that you're not eating enough.
But you want the solution that solves the problem as effectively and as narrowly as possible. Unless your underlying problem is actually a B6 deficiency, it's completely plausible that B6 could be more effective than placebo and less effective than Adderall. At which point nobody wants to hear you telling them to give up their Adderall for B6.
The fact that I can read up on this as a civilian compared to your expert level knowledge is something I am deeply grateful for. Truly!
Energy still comes from food, and if you forget to eat on stimulants your body will eventually catch up with you.
Like coffee, stimulants let you better tap into that energy.
> The mechanism of action (norepinephrine and dopamine reputable inhibition) isn’t far from that of cocaine or methamphetamine.
Yep, they’re all stimulants. ADHD meds however, are manufactured in very controlled conditions, and taken in specific doses. Street drugs are more variable in quality, ratios, ingredients and strengths, and so not relevant to the treatment of ADHD.
Methamphetamine is a legitimate treatment for the most severe ADHD cases, it’s often a last resort. It’s sold as Desoxyn. It’s rarely used, but it _is used legally and successfully_.
> Let’s be real here. Amphetamine is known to skew one’s self assessment of their performance while on the drug.
If you don’t need it, stimulants are going to have a different effect.
People with ADHD are in my experience, going to be able to self-assess performance on their meds better than off them.
Don’t assume one experience is universal, especially when we’re talking about neurodiversity. Even among those with ADHD, experiences are not universal. We may rhyme, but we don’t always repeat.
Imagine doing the dishes. Unmedicated, thats 2 or 3 tasks. Each with a high failure rate, and high cognitive cost.
1. Stop what you’re currently doing. 2. Decide you next task will be to wash the dishes. 3. Wash dishes.
The spoon theory [0] covers this concept well, and can be a useful tool.
> The spoon theory[a] is a metaphor describing the amount of physical and/or mental energy that a person has available for daily activities and tasks, and how it can become limited.
Sure, there’s also some risk for patients using them properly, but for them it does not compare to the sheer benefits provided by the meds.
Instead, look to nutrition.
However there's a general understanding of ADHD (and related disorders such as ASD) as a spectrum of conditions with multiple contributing factors. Depending on the person ADHD will manifest with more or less hyperactivity, distractability, working memory issues, and lacking emotional regulation (among other things). Different causes combine to give a somewhat amorphous disorder with a range of common symptoms.
So adding a new treatment with fewer downsides (because stimulants can have a few) is great, especially as it might treat aspects of the disorder that aren't treated by stimulants. But this doesn't mean stimulants won't still be relevant in the future.
There's there's also plenty of research showing specific dopamine receptor dysregulations as contributing to ADHD. See for example https://www.researchgate.net/publication/364120700_Dopamine_...
So unless the research also shows that this is caused by pyridoxine metabolism problems, these hypotheses can both hold at the same time.
Picking some paper that talks about different causes doesn't mean other causes aren't still relevant. It will probably be decades before we can definitively rule out contributing factors.
PS It's generalizations like yours that are very stigmatizing towards stimulant use. We already know many people benefit from them enormously and significant numbers are not getting or taking them due to stigma.
Just try taking high dose P5P.
And probably zinc:
https://www.nature.com/articles/s41598-021-94124-5
If you knew the metabolic pathways thus would be as clear as day. We need enzymes to make neurotransmitter and those enzymes need cofactors to work.
Two, If you did, how much did you take? And what type? Pyridoxine or Pyridoxal-Phosphate? For how long? Were you tested for a B6 defieicny, high homocysteine?
Three, it is in NO WAY common for deficiencies to be tested for mood disorders and even less common for a doctor nevermind a psychiatrist to do anything about it.
And calling me an asshole when I am advocating for better health is making everyone's life worse. I do not mind if people choose to take stimulants, but they are not being advised that there are other options.
That makes you an asshole.
> Three, it is in NO WAY common for deficiencies to be tested for mood disorders and even less common for a doctor nevermind a psychiatrist to do anything about it.
Why do you believe this? It is easy and cheap to do a blood test for deficiencies, I have done that many time and they found I lacked nothing. Do you have any evidence it isn't common to check for deficiencies, because to me it seems like that is one of the first thing they check.
Because I have worked with health care professionals for 20 years and they do not test for nutritional deficiencies unless you ask/beg them to. This is even more true with psychiatrists. I am advocating right now for a woman with a serum B6 deficiency that her doctor will not address. She has an actual serum B6 deficiency and anemia and depression and her dopctor thinks it is not importnat. That is why.
> It is easy and cheap to do a blood test for deficiencies, I have done that many time and they found I lacked nothing.
There are deficiencies and functional deficiencies. Plus there is serum B6 and RBC B6. Have you had your RBC B6 tested? Nope.
And Homocysteine levels will reveal more than serum B6.
And I do not believe you because you did not answer "how much did you take? And what type? Pyridoxine or Pyridoxal-Phosphate? For how long? Were you tested for a B6 defieicny, high homocysteine?"
Then reason you are an asshole is that you are asking questions that takes a lot of work to answer since most wont know the answer to them on the spot. That is a very common tactic when you try to push your pet theory on others, but you should know that nobody thinks you won the argument when you do that they will just see you as an asshole. Even if you are doing it to be nice, you will be seen as an asshole, so please stop doing that.
People I know take 30 - 60mg of P5P to feel the effects.
You were not taking high dose B6, just the RDA, and that will not do anything. And it will not correct a deficiency.
You think it takes a lot of work to answer? What about all the work I do looking into this and asking? For who? For you. Instead of calling me an asshole understand that I am helping you, for free, unlike your doctors.
So you cannot say taking B6 did not work for you.
If a B6 deficiency cured your ADHD would you still want to take stimulants?
Assuming you mean “if treating a B6 deficiency”, and assuming I had strong expectations that I could expect a cure, I’d consider giving it a try. I’d be cautious about any transition, as it could mean either significant side effects while still taking stimulants, or significant regression without them if the B6 treatment doesn’t work as hoped.
But I don’t even have a strong expectation that I could expect equivalent or better management. The study you linked was conducted with children, and the conclusions based on observations of children’s behavior. Maybe that’s a good indicator that it’s helpful, but I have no clue. I wasn’t diagnosed as a child, my ADHD was noticeable to one adult in my adulthood enough to mention it, and my experienced symptoms are much closer to autism (again as experienced by adults, not as behavior observed in children, although those diverge much less for me). But the things mentioned improving in the study are very much not what I’ve struggled with having ADHD as an adult, nor things for which I sought diagnosis or treatment.
The way diagnosis and treatment saved my life was helping me manage crippling anxiety and helping me make chronic depression manageable. It’s possible that exploring a nutritional deficiency none of my doctors have found with supplements no one has studied for adult ADHD… it’s possible that would benefit me. It’s a very high risk proposition given I have meds which work for me and which present no side effects so negative I’d reconsider.
Moreover I haven’t had a single medical professional raise this possibility and with good reason. My treatment is working. Even if an alternative treatment might be promising… why would any responsible doctor propose disrupting a persistently successful treatment plan?
I don’t know why you’re so motivated to disabuse me of my effective medication, but you’ll have to do better than showing a study which made children more tolerable. I credit my life to the meds that I take now, and there’s very very little I could fault them for. Asking me to reconsider that is asking an AWFUL lot.
You go on and on about how you don’t think it would work, but have you ever had your B6 level tested never mind your red blood cell B6 levels?
I get it, you don’t care, you found a treatment that works, even though that treatment is not curing the underlying disorder. It’s just a treatment. I get it it works, until it doesn’t. I’ve been working with people with new disorders for 25 years and I’ve seen it over and over again.
So I’m not asking you to stop taking anything I’m asking you to keep an open mind which you seem to not be able to do. That’s OK.
> I mean you did not even bother to search for another paper.
I most certainly did. The search results I got were primarily ads, and few clinical studies I found were, like the one you linked, far less bold in the results they claimed than your claim of a “cure”.
> You make me assumption that I’m trying to disabuse you of taking your medication. I’m not. I don’t care, take it if you want. But by not being open to other methods of treatment, you aredisabusing people of that choice.
Excuse me, how?
> You go on and on about how you don’t think it would work
The studies themselves don’t support your claim of a cure.
> but have you ever had your B6 level tested never mind your red blood cell B6 levels?
No, I haven’t been to a doctor since some person on the internet mentioned this a few days ago. I did have a scheduled psychiatrist appointment in that time, but had to reschedule because il out of state for a family medical emergency.
> I get it, you don’t care
I don’t know where you got that impression. I took the time to reply thoughtfully and, despite your impressions otherwise, to look for other studies more pertinent to my own experience. In my thoughtful response I expressed caution and the reasons for that caution, which you completely ignored.
> you found a treatment that works, even though that treatment is not curing the underlying disorder
That’s right. And it’s important. It’s the reason I’m still alive. I’m cautious about upsetting treatment that works because I would very much like to remain alive.
> I’ve been working with people with new disorders for 25 years and I’ve seen it over and over again.
I don’t know if you mean the disorder is new in the world (it’s not) or in me (it’s also not).
> So I’m not asking you to stop taking anything I’m asking you to keep an open mind which you seem to not be able to do.
I don’t know where you got that impression. An open mind isn’t characterized by immediately accepting life changing “solutions” proposed by random people on the internet, regardless of whether they cite medical studies. I expressed an open mind, I said I’d consider giving it a try.
> That’s OK.
In your own words, I don’t believe you. You have talked past me and several others in this thread, and you don’t seem to want to accept anything other than a revelation that what I need is vitamins rather than the treatment that my doctor prescribes. You have even suggested that I’m preventing other people from treatment (or a “cure”) you think more appropriate simply because I haven’t dropped everything to try your preferred treatment. If this is how you “work with” other people who are hoping to treat their ADHD effectively, god help them. And it has nothing to do with the particular treatment, I felt the same way about my first psychiatrist who was just as zealous about stimulant treatment.
Maybe use PubMed and not google?
> you don’t seem to want to accept anything other than a revelation that what I need is vitamins rather than the treatment that my doctor prescribes.
I NEVER SAID THAT ONCE. Take stimulants if you want, but just because that is your choice do you need to be so outraged by the idea that B6 might work just as well?
>> But by not being open to other methods of treatment, you are disabusing people of that choice.
> Excuse me, how?
YOU: Moreover I haven’t had a single medical professional raise this possibility and with good reason.
You: But I don’t even have a strong expectation that I could expect equivalent or better management.
You: I don’t believe you.
This negative stance only feeds on this idea that medications are the only choice, the only answer, and that nutrition never works becasue "there are no studies" or "My doctor did not recommend it".
You are just shooting down the idea that this might be the root of the issue. And yet you have never even had you B6 levels tested. That is just willful ignorance. Have you worked in Nutritional Genomics? Do you even know why treating a B6 deficiency might be important not just for your behavior but your over all health? If you have a B6 deficiency and take stimulants to cover up the symptoms, what about all the other enzymes that need B6 to function?
Over and over they find B6 deficiency in ADHD. There will be no studies showing the efficacy of B6 because there is no funding for products that do not make a profit. You are on stimulants because they work and they are profitable.
Next thing they will get you to take will be Metadoxine. Ha!
https://pubmed.ncbi.nlm.nih.gov/25295645/
https://pubmed.ncbi.nlm.nih.gov/23290324/
Hmmmm...I wonder why they were trying out Metadoxine for ADHD, and wonder why it failed...oh....Metadoxine, also known as pyridoxine-pyrrolidone carboxylate. So they made a funked up version of B6? Why would all these smart science people want to make a funked up version of B6 if B6 was not linked to ADHD?
Do you think maybe they know something they do not want you to know? And maybe that is because ADHD meds brings in about $20 Billion for these companies?
Have you thought you do not want to hear anything but stimulants are the only answer for you? And that I am not talking past you but that there is no one there who wants to listen?
I normally hate to quote this but it fits: calmer than you are.
> You are just shooting down the idea that this might be the root of the issue. And yet you have never even had you B6 levels tested. That is just willful ignorance.
My gosh, you’re being a jerk. I haven’t had my B6 levels tested in the last few days because it’s in the last few days and my medical appointment was canceled because I’m out of state for a family medical emergency! Have you thought about the fact that I literally physically cannot meet your expectations of an open mind and that your expectations are totally unreasonable?
I was asking if you had your B6 levels tested ever, not in the last few days.
You’re reading what I wrote much more dramatically than it is implied. The fact you think I am really telling you to run out right now and get your B6 tested is distorted.
There was a decade between me first seriously suspecting it, and that.
Information about it is much easier to come by now, and more people talk openly about it. Without that, I probably would have struggled for much longer.
That is profound. Also says a lot about us as humans. Glad it's not raging anymore
Hard to see how this is "especially true" with stimulants, given they're the rare case of psychiatric meds you can get on and off safely at any time, and the bulk of the effects appear in hours to days after starting the treatment (and disappear just as fast after cessation). Contrast with e.g. depression treatment, where it takes a month or more before it's clear if the drug even works on you, and which of the bad side effects have a chance of eventually going away.
"Long-term positive" is impossible to know in individual, non-statistical sense, whether it's about stimulant medication, SSRIs, moving to another city, marrying, or starting a family - any of those is going to have cascading impacts on your entire life, and even if you think they're positive after a month/year, who knows, maybe few weeks from now you'll think they were negative. That (otherwise stupid) "Farmer's Son" story has a point here.
Maybe you can get off them safely, but not always easily. My alcohol/drug recovery group is filled with people who couldn't easily get off them, like my friend N., who rather than swallowing his medication (Ritalin?), he crushed it & snorted it like cocaine.
You're implying addiction, but in the more common case, people with ADHD can be apprehensive about getting off the meds for the same reason people with chronic pain can't easily get off painkillers, or people in general can't easily get off oxygen.
> like my friend N., who rather than swallowing his medication (Ritalin?), he crushed it & snorted it like cocaine
That's just drug use, not ADHD treatment. I wonder what your friend's dose was? Snorting instead of swallowing is massively increasing the absorption rate, but even then, I don't think you can get high like this, if you just do your regular regimen through the nose. But doing a week or month's worth of pills this way at once, I guess sure?
I don't have the data handy, but IIRC the difference in dose size between therapeutic effect and drug abuse that leads to addiction is ~100x.
There is no side-effect to glasses, you can put them on or off completely at-will any moment, and they make a very exact correction to one specific parameter (vision focusing ability).
ADHD meds are imprecise and affect many systems in different ways - some positive and some negative. You can only have them on/off daily. It might affect you differently depending on other factors. And treatment is not without risk.
It’s hard to understand how stopping will affect you due to the imprecision. It’s not as black-and-white as glasses.
But stimulant meds still don’t deserve any more stigma than glasses. For those who take it as part of treatment of a lifelong disability.
Edited to add: Btw, try playing squash or go swimming with kids. Suddenly your glasses aren’t the perfect solution that they may otherwise seem to be and they become yet another tool, like having the kids wearing bright swimming clothes so you can spot them in a crowd.
But you’re right, we’d love for ADHD meds to be as effective and universal as glasses, but they’re not. Probably because ADHD isn’t a single condition, but a spectrum of conditions with some overlap. So expecting a single treatment to take away all symptoms is a fantasy.
Anyways, I'm skeptical of that 100x number. Comparing 5mg of adderall to 50mg, I could easily imagine getting addicted to the euphoria from the latter and spiraling. I can't even imagine 500mg of adderall, that's just an absurd dose.
I could maaaybe imagine that the 50mg dose resulting in a sorta psychological addiction and 500mg being more physiological, but it doesn't really line up with the model I've built from my own experience. Of course, everyone's different
I’m sorry but this is just beyond silly.
You don't even need that much - a 10mg pill crushed and snorted (it will make a few lines) will fuck your shit up.
Its not a particularly fun high though, it comes with compulsive redosing, discomfort (skin crawling), and basically feels like the latter half of a cocaine bender - after the fun has ended but you are now just fiending.
Other fun ways to abuse methylphenidate at low doses include exploiting its synergy with alcohol and prozac to get, again, a rather cocaine like high, but much more enjoyable than just railing lines of the stuff, and lasts a few hours.
As for treatment of ADHD symptoms, personally I found dexamphetamine worked a lot better than methylphenidate for me, but its much harder to get prescribed.
I'm having a hard time pinning this on the meds honestly...
Having done exactly that (crushed and snorted Ritalin) in the past. I can't recommend it - its not a very good high.
They do not tell you that part for obvious reasons, but if you find the right doctor to explain the biochemistry of how they work it then becomes obvious.
Rhodiola is MAO inhibitors and so is Ginkgo, while 5-htp is the serotonin intermediate and corresponds to SSIs. Not to say that you need not to be careful, that still is required but with other cofactors consumed you can micro-dose.
Note, due to my understandings of what cofactors I need I do in fact micro dose L-DOPA as some recommend 500mg but I only consume 20mg daily.
Cofactors such as aromatic amino acids to increase tryptophan absorbtion across blood brain barrier including Macca extracts and fenugreek and Phenylanaline .
edit: feeling great only applies to some stimulant medications and seems to vary from person to person. Personally, I hated the pharmaceutical stimulant experience but they still helped me. I would be taking meds right now if I could afford it.
People say, medication is an aid, a crutch. Well guess what, when your leg is broken, you kind of need that crutch to move around. There's no shame in using a crutch. And if you lost your leg, or happened to be born without one, then guess what, using crutch for the rest of your life is not anything to be ashamed of, and it's rude to suggest it is.
Do what you need to do, don’t make other people feel bad for not doing what you do.
If, for example, you've been taught to walk without your leg (or if you have three legs, all left feet, whatever), using a crutch doesn't make much sense.
We can't safely poke someone's head and test their dopamine levels. So we aren't good at differentiating what could potentially be learned cognitive behaviors | brain structure | genetics from hormonal neurology. Hell, these could all be the same thing on so many levels, but it takes only one to mark a meaningful difference.
Point is, different people are different. And it's rude to think you know someone's experience well enough to liken it to "punching yourself in the face".
That said, if medications cure you altogether, there's nothing better. But ADHD, unlike other conditions, seems to relapse a lot.
Again with the stigma.
There’s little medical reason to expect stimulant effectiveness to change after the first couple of weeks, the “honeymoon period”, during which the mood lifting effects are most pronounced. It’s also that same effect that is the main attraction for abusers because it can give euphoria in high enough doses. And yes, that mostly goes away.
But other than a possible slight increase in dopamine re-uptake due to a long term increase in dopamine (over what’s initially a dopamine deficiency as far as we know), there’s no long term habituation (as far as we know).
If you feel better without medication, that’s fine, but please don’t guilt others into throwing away their metaphorical glasses.
Receptor density might increase, but that's negligible in the system compared to the starting density of transporters at therapeutic doses.
I already needed them as teenagers, but my mother was against it, because I should not grow too dependent on them. Because she says if you wear glasses, the eye adjust to the glasses, so you see as bad with the glasses, as you did without glasses. Then you need stronger glasses, and every time you get stronger glasses, they make the eyes worse, until they make you almost blind. The opticians are destroying your eyes on purpose, so they can sell more glasses
I only got glasses as adult because it was mandatory to get a driving license. I actually got an anxiety attack in the driving exam and failed the exam, when I had to put my glasses on because I was still convince they make you blind.
I wonder if I have ADHD, too. I am completely unable to participate in classes, but my grades in exams were good enough that no teacher suggested testing. It is like I have zero attention on anything said in class, but then hyperfocus on reading/writing/programming stuff. Anyways my mother would not have allowed me to go to a psychiatrist, because she think that psychiatry is a scam. The psychiatrists are only trying to get you addicted to drugs and destroy your health on purpose, so they can sell more drugs.
Or it might be because I could not see anything in class. Then I had to stare at something and try to recognize something in the blur, and that was taking away all my attention. But reading things in close range worked fine without glasses. Perhaps degraded sensory input is actually a cause for ADHD. The brain diverts too much processing power on processing sensations, and there is not enough processing power left for the actual task, and it makes any sensation (distraction) appear much more important. I still cannot participate in classes even with glasses
My partner always had a thing for amphetamines, and was more functional under influence. It just took a doctor to confirm and subscribe them to suddenly make it legal. I could not say the same about myself, amphetamines just make me more awake but not more functional.
But indubitably, the person on 2 hours needs it much more.
If you feel like you need stimulants to perform well in a job, you need to reconsider your career choices. It shouldn't be a rat race.
OR you may have a medical condition such as ADHD where stimulants are a useful prescribed tool to deal with it. Not everyone who needs stimulants to work is abusing them.
Would you say the same thing to someone with a physical handicap? I.e., "If you feel like you need a wheelchair to get around, you need to reconsider going outside the house"
I'm not trying to put words in your mouth, not saying you'd say something like that, but consider it from the medical perspective. Someone shouldn't have to struggle with a handicap just because it's mental instead of physical.
Medication is a useful diagnosis tool, because the effects when it helps can be utterly profound. For me it was like I’d fully woken up for the first time in my life. My body physically calmed down, and I went from spending the majority of my idle time daydreaming to being calm and present in the world.
Please don’t take other peoples pills though, they’re tightly controlled usually with no buffer. If you take someones pill, that means they’ll have to reduce or skip a day. Imagine stealing someones reading glasses for a day—they’re gonna have to persist and deal with the possible migraine/eye pain.
> I found myself focusing and intetionally task switching for about two hours (that and palpitations), but I wouldn't say they "help"ed me.
You don’t need them. What you experienced is not what your GF experiences.
If you put on someone else’s prescription glasses, would you complain that they didn’t help you?
> It shouldn't be a rat race.
Everyone I know on stimulants for ADHD (myself included) would agree that the stimulants help them escape feeling they’re in a rat race.
A trait of ADHD is know precisely what needs to be done, and being incapable of making it happen. Medication helps with that. It’s not a cure. It doesn’t fix everything. It just makes some things easier.
I never had a racing heart taking it and it didn't elevate my tension. It allows me to take a nap when I want without those racing thoughts about "life"
If you need Ed medicine to have sex maybe you shouldn't have sex.
If you need asthma medicine to breath maybe you should think twice about breathing.
Seriously, you don't have a clue about what you're talking about. Neuro divergents are almost an evolution good or bad (hyper focus can have it's benefits), most medicine for the brain is liable to do the opposite.
Caffeine and ginseng are like really good cold medicine to my wife she practically goes into a coma.
If you don't think people's brain work differently:
Do you have an inner monologue?
- yes? - talk to someone who doesn't, there's many, I found this absurd because mine is always going. - No? Talk to someone who does... Try to imagine what it'd
Repeat the above for people with synesthesia or aphantasia.
Reality, the brain, consciousness... It all exists within the circuitry of our brain and the flow of electricity and hormones paint your experiences in life
With a deficiency in dopamine which we all mostly have (ADHD), you do need help.
For you, you could end up overdosing on dopamine which itself can cause some major mental issues.
Best to lay off other people's meds.
Hell, I take Vyvanse my wife Adderall, when I ran out I took hers as she's on a dose that about matches my vyvanse but they have different internal mechanism.
Adderall gave me anxiety, depression, and jitters.
Even within ADHD circles it's probably best to stick with the meds you're prescribed.
Or if you dislike thinking of it as a disability (even if there’s nothing morally wrong with being disabled): a pair of glasses.
Do we really think less of people (or in this case likely ourselves) for using a wheelchair or wearing glasses?
But I've changed my phrasing, just to be clear.
I don't want to get addicted to another thing in my life, here in Europe we're quite familiar with (ab)using speed (amphetamine paste) and the idea of being on speed every single day seems pretty bad.
I don't feel "more like myself" on speed and I seriously doubt most positive effect would persist after a year of using and rising tolerance.
Why? Just because it comes in a pill form, instead of being conspicuous, doesn't make it any less of a help for a medical condition.
> I don't want to get addicted to another thing in my life,
The point of this comparison is that "being addicted to" ADHD meds is not in the category of "being addicted to heroine" - it's in the category of "being addicted to a wheelchair" when you could technically just use your hands to crawl around and grab things, instead of aiding yourself with technology.
> the idea of being on speed every single day seems pretty bad
Stimulant medication aren't speed, they're like "1/100 speed". It turns out that with medicine (not just psychiatric), the effects don't scale linearly or continuously with dose size. That's why those meds are helpful and safe to take in therapeutic doses, despite being technically dangerous, addictive drugs in much larger drug abuser doses.
> I seriously doubt most positive effect would persist after a year of using and rising tolerance.
Countless of people who have been treating their ADHD with stimulant medication continuously, for years or decades, will beg to disagree.
Nobody says you have to take meds for ADHD treatment, or that you have to take stimulants (there are other options available, although typically less effective). Hell, on some people with ADHD, stimulants don't work at all, or side effects are not worth the cost. But comparing them to speed is just wrong and irresponsible, as it makes people afraid of trying what could be effective treatment.
Seems pretty strange that I should take your sourceless claims as gospel over theirs.
>Stimulant medication aren't speed, they're like "1/100 speed".
These are literally two identical substances with almost identical effects (the only difference is the ration of amph salts). Difference is dosage.
Can't understand why would you claim what you say, when Adderall is used and abused in the same exact manner as amphetamine paste is in Europe. Anecdotally I hear in USA they throw it at you like candy.
>But comparing them to speed is just wrong and irresponsible,
I stand by what I said, if you saw the numbers of amphetamine addicts on the street in USA the same way you see opoid addicts, you would have a different national perspective on these drugs.
>it makes people afraid of trying what could be effective treatment
Yes, they should be cautions in my opinion.
I personally am not taking any new chances with addiction, even though I'm sure I would have benefits, at least short term.
I'll just hobble along. Using crutches can make physical rehabilitation impossible.
Excuse me? There's roughly 60 years of research into the effectiveness of stimulants as a treatment for ADHD. It is probably the single best researched psychiatric drug.
While it's always useful to discuss a proven treatments relevance in the light of newly discovered alternatives, there really is no (significant) doubt in the scientific community about the effectiveness of stimulants. Given the body of evidence, I would say it's more fair to ask you to add some citations to your comments.
> These are literally two identical substances
Yes, they are. That doesn't mean that in patients with a dopamine dysregulation they don't have great therapeutic effect. One could call the euphoria nothing but an unfortunate side-effect leading to abuse in the general population.
> numbers of amphetamine addicts
So, there are addicts. That has nothing to do with therapeutic use.
> Yes, they should be cautions in my opinion.
Since they aren't prescribed to self-diagnosed ADHD patients, there should always be a doctor involved. And I can tell you the titration and monitoring is taken quite seriously, at least where I'm from.
> Using crutches can make physical rehabilitation impossible.
If you're missing a leg, that rehabilitation is going to take a long long time. As will be the case with ADHD. You might learn to cope better, but your symptoms aren’t going anywhere. ADHD isn’t something that generally gets better with age, although better coping skills may mean some people don’t experience as much of an impact on life.
And yes, stimulants are a crutch, but they do help people function better despite their disability.
So instead of focusing on bespoke medications we try to ban them all if a small percentage of people have addictive natures or negative side effects.
How about we agree that drugs can be beneficial and harmful, but keep them legal for the large percentage of people it actually helps.
Not every disability is visible. By definition they have a significant impact on someones life, as such there isn’t use for competition.
A wheelchair is a great comparison. Both enable someone to do something they previously couldn’t. Both are temporary, and stop being useful when removed. Both have a very different effect on someone who does not need them.
> I don't want to get addicted to another thing in my life FWIW, among those I know with ADHD taking stimulant meds, addiction is not a concern but remembering to take them is.
> I don't feel "more like myself" on speed
Do you have a deficit of dopamine, serotonin and norepinephrine? If not you’re experience will be very different from someone who does. Even then, some stimulants work better for certain people, and for other only non-stimulants work. Our brains are complex, and our experiences are not universal. Speed is also a pretty catch all term, and the ratios of salts have a huge impact on the effect. It may not be very comparable to pharmaceuticals.
> I seriously doubt most positive effect would persist after a year of using and rising tolerance.
People have been taking stimulants for ADHD for decades, but I think its effect is not what you think to an ADHD brain. It’s more akin to reading glasses.
What evidence exists that points this is the cause of ADHD? Wouldn't a dopamine deficit be more akin to Parkinson's Disease?
Also, last I remember reading, I am pretty sure we are not fully aware of why stimulants help people with ADHD. I think the leading hypothesis is that dopamine plays a role somehow, but I thought that he yet to be fully observed.
I don't give a shit about my job but it allowed me to buy a house, take vacations and sometimes buy an extensive toy.
I would gladly stay in my own world and daydream away, doing some woodworking and see birds in my garden but if I lose my job all that will go away.
So I take my ~3€/day pill and try to do my best. I've lost so many opportunities before getting diagnosed...
I'd only manage that for about two days before giving up without the meds, heh
It allowed me to stop eating my feelings (which allowed me to lose 13kg and counting), made me stop drinking, I still play games but can stop whenever.
I know I will surely have to take it my whole life (days I don't, I'm a wreck) but I see it as a diabetic needing insuline.
For example, stim meds increase my focus but also seem to reduce my creativity and injure my sleep (to the point that I have occasional short-term memory loss). So every day I individually evaluate whether it will be worth it or not, and I make sure to take at least a couple days off a week to catch up on REM sleep.
I don't need meds to live. I need meds not to feel hollow in my soul. If I think about doing something that is meaningful, I need my meds to up and do it. Otherwise it's living the life of someone with really great plans that are unable to leave their head. It is hellish.
Now I have 35 unmedicated years to catch up to.
I did the titration regimen after my diagnosis with a licensed psychiatrist and ADHD specialist, so you start very low and test a dosage for a month at a time. You increase it slightly until side effects are noticeable. This was my timeline:
Euphoria lasts perhaps two days, and you're on the lowest dose so it's pretty mild. You're just doing something and feeling happy about yourself. Good, it's a side-effect, and needs to go ASAP. Many people start on too high a dosage, so euphoria lasts maybe weeks, and when it stops they think it stopped working. This opens the doors wide open to abuse, especially in teenagers.
Adaptation, during which other negative side effects start to lessen, lasts about 10 days.
Then there's peak productivity with little side effects for 6 months or so.
Then you start to question if it is still doing anything. There are days that you just don't feel like doing much. Take a couple days off, and it's obvious it was working all along. Without it you're still unproductive and scatter-brained as you've always been without. Also, you've started getting good at using this new powerful tool, but still don't know what to do with it. This is where I'm at at the moment.
--
When you're used to having good days, good days become normal days and it is very hard to remain objective in your assessment.
This is key to appreciating the value of the medication and also benefits as a way to fight tolerance. "Medicine holidays" it's often called. Every month take a weekend off, and every 6 months take a week off. Those off days will leave you terribly lethargic. But going back on will make you really appreciate it. Or not in which case take a longer break and maybe lower your dose.
I wonder if the dopamine system might need more than a few days to reset. In my experience with addiction, it takes months.
I've been on adderall for 20 years and haven't ever had to increase my prescribed dose. I even usually reduce my dose in the summer after my week-long break. I bring it back up after subsequent holidays in the autumn.
The only times when I've thought it wasn't working, the med holidays brought it right back on track.
Could be placebo. Also n=1. There's very little lost in attempting (it assuming your dr is kosher with it).
What was good to know was that there doesn't seem to be any addiction potential for me at all. I hate being lazy and unmotivated without the meds, but there is no urge nor withdrawal whatsoever, which is fantastic, as someone that got addicted to half a dozen things in their life.
I was afraid I would start to enjoy the meds too much, but I am much more dependent on the cup of coffee I drink once a week (and every day during work I start craving a Coke) than amphetamine.
The fact that the medication is out doesn't make your dopaminergic system more sensitive by itself. It might take a while.
So, my dopaminergic system probably has holes burned through it.
I really hope it keeps working in the longer term because it's been life changing so far.
The best explanation I've seen is this comic: https://teddit.net/r/ADHDmemes/comments/pmrh5d/quite_possibl...
I quit my meds when I was about 16/17 failed out of my last year of highschool, went on to become a construction foreman for huge projects managing crews of 30-40.
During a layoff in 2009 because there was no construction, I installed linux on a laptop because I borked my OS and didn't have a key. Ended up getting a job as an ISP call center tech at a small ISP/hosting company a few months later, taught myself systems and networking administration and was running the whole place a few years later including the BGP peering, system automation, monitoring, and building.
I went to work for a FANNG for a decade, Built some cool shit, have a few patents.
When the pandemic hit, I really stopped for the first time and looked at what being able to perform at a high level was costing me and my family.
1. I was drinking too much, a small buzz would slow my mind down and let me focus on a single thing, It kinda works but at what cost?
2. I always knew what I needed to do, I understood how to build what I needed to build but there would be times, whole weeks, when I'd be unable to bring myself to read the docs I needed too or do what ever I needed to do, that would make me uneasy and lead to a lot of self-loathing. Not a great person for my family to be around during those times.
3. Always feeling like I needed to work but never working, so everything was an inconvenience because I should be getting something done at work but I wasn't, then things like dinner with my family felt like it might be taking away from some work I wasn't going to do anyways.
4. The lightning would strike, I'd find a deadline or whatever and I'd work, almost unbroken for days straight, online before my kids got up, get them to school, work, pick them up and make dinner/put to bed, work through the night or late into the night.
5. I'd build the thing I needed to and then I'd crash and be tired, and then I'd have a day or two to be the father and partner and person I wanted to be, but there's always the nagging feeling that next time, I'll be too late or won't pull it off . . ..
I spent 2 years in therapy (starting before the pandemic) addressing the symptoms and working on Cognitive Behavioral Therapy techniques to address a chemical imbalance in my brain. Working on being kind to myself, working on stress management, working on time management.
Part way into the pandemic, I ended up quitting, realizing I just needed a break and I was working so much harder than any of my peers for a similar or worse output. Them mental overhead of keeping up was excessive.
Eventually, I went back and got properly medicated. It was like a switch flipped. It took me a month or so, to get into it, but I found myself feeling like I could stop and be available for my kids whenever, because I started to realize, I could just turn my focus on and off whenever I wanted and I didn't have to wait for lightning to strike.
The thing that's most beneficial is a bit unseen, I'm not carrying a burden of self-loathing, fear, anxiety on my back, all stressors that were a result of my inability to entirely control my focus and do the thing that I wanted to do when I wanted to. That invisible weight that I carried everywhere vanished.
I've seen a marked improvement in my life over the last year or so. I'm a better father, partner, employee. I like myself for the first time in decades.
This is long winded, but I wanted to put this out there because there are a lot of us in tech. having ADHD is actually a great way to get into tech, we find something we don't understand or a blocker and dig deep. I was just trying to find a way around a license key and ended up learning internet routing . . .. I have a very broad skill set because I'll dig deep on anything that walks by. I see many like myself. But if you find yourself in a cycle like this, go get help. Life doesn't have to be that hard.
So I'm like this just not as 'successful' AND I haven't gone medicated as I'm on the cusp. Although, I've been putting something off for a while....;)
'The thing that's most beneficial is a bit unseen, I'm not carrying a burden of self-loathing, fear, anxiety on my back, all stressors that were a result of my inability to entirely control my focus and do the thing that I wanted to do when I wanted to. That invisible weight that I carried everywhere vanished.'
I am currently in the mindset that I don't get to choose what I do. I either do it, or I don't and that has forced me down a route to where I find myself. Which has really worked out. But only because I caught myself and that those knife edge moments went the right way.
The problem that I found as I got older is there's substantially less room for just going with the flow. It worked great for years. Now I have people that I'm responsible to and do it or don't do it doesn't work. I can't just leave it to chance if I sit down and read with my kids daily or cook them healthy foods. Their lives will pass by while I'm wondering around waiting for the inspiration to be a good parent.
So a heads up, that works great when no one depends on you much. It works a lot less great when you owe people things that you really care about.
This has helped me to do the things that I want to do. It more helps on the task level and less the overarching job level.
I still don’t subscribe to ‘it’s all ADHD’ where everything gets lumped into this block of behavioral reasoning.
I think it’s at an OS level but I think we are just a little more sensitive than non neurodivergents. And that comes with some huge benefits as well as negatives.
When I was young, it was just 'here take this'. No help with understand what was happening or how to work on it. And I think that's a bad place to be.
I've been experiencing the exact same emotions/habits you mention for the past 5 years especially, now that I have a wife and child and it's been extremely stressful and I've been less than fun to be around unless I'd found a way to be super productive that day or perhaps after a couple drinks.
I took adderall for the first time in years yesterday coincidentally, and felt like a new person. I could work through the stuff that I'd been putting off for weeks. My house wasn't a disaster zone with baby toys everywhere.
So all of this just to say, thanks for your write up. I'm going to look into CBT as well and maybe get back on the meds permanently. My only concern is the come down where I was left feeling terrible, but I hear they have better stimulants than adderall these days so perhaps I'll give another one a shot.
I can feel the medication starting to wear off around 4PM and get sucked into the time blindness and must work/play rather than spend time with my family.
Thanks for your message. Eyes opening
punching myself in the face for no reason
Last month I saw a psychiatrist and got a prescription for stimulant medication for the first time in 20 years. After a week I had to sit down and just cry: stuff which was difficult or stressful was just simple, and at the end of the day I have so much more energy to do things, to be present, to live my life. The medication is an aid, a crutch, sure, and I don't need it, but it makes my life better, easier, less stressful and less tiring.
Why are you punching yourself in the face for no reason?